[1]陈世雄* 许家君 陈胜家 方政 刘贤丰 陈恺.剑突下入路胸腔镜前纵隔肿瘤切除术24例[J].中国微创外科杂志,2023,01(5):332-335.
　Chen Shixiong,Xu Jiajun,Chen Shengjia,et al.Subxiphoid Approach for Thoracoscopic Resection of Anterior Mediastinal Tumors: a Report of 24 Cases[J].Chinese Journal of Minimally Invasive Surgery,2023,01(5):332-335.
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剑突下入路胸腔镜前纵隔肿瘤切除术24例()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2023年5期
页码:
332-335
栏目:
临床研究
出版日期:
2023-05-25

文章信息/Info

Title:
Subxiphoid Approach for Thoracoscopic Resection of Anterior Mediastinal Tumors: a Report of 24 Cases
作者:
陈世雄* 许家君 陈胜家 方政 刘贤丰 陈恺
(九江市第一人民医院胸外科，九江332000)
Author(s):
Chen Shixiong;  Xu Jiajun;  Chen Shengjia;  et al.
Department of Thoracic Surgery, Jiujiang First People’s Hospital, Jiujiang 332000, China
关键词:
剑突下; 胸腔镜; 前纵隔肿瘤; 胸腺瘤
Keywords:
Subxiphoid; Thoracoscope; Anterior mediastinal tumor; Thymoma
文献标志码:
A
摘要:
目的总结剑突下入路胸腔镜手术治疗前纵隔肿瘤的经验体会。方法2018年11月~2021年12月我科对24例前纵隔肿瘤采用剑突下入路胸腔镜前纵隔肿瘤切除术，在剑突下做一长约3 cm纵形切口作为观察孔，然后在左、右侧锁骨中线肋弓下方做一长约1、0.5 cm切口作为辅助操作孔，超声刀完成前纵隔肿瘤切除术。结果24例采用剑突下入路胸腔镜胸腺扩大切除,1例因肿瘤大且累及左侧头臂静脉和心包，辅助胸骨上段J形小切口完成手术。术中操作时间平均65 min(45~150 min),术中出血量平均50 ml(20~100 ml),术后胸管留置时间平均2 d(2~4 d),平均住院时间5 d(3~7 d)。1例发生左侧膈瘫, 未发生其他并发症。24例术后随访1~36个月，中位数17个月，未见复发及转移。结论剑突下入路胸腔镜手术治疗前纵隔肿瘤安全有效且可行。
Abstract:
ObjectiveTo summarize the experience of thoracoscopic surgery for anterior mediastinal tumors through subxiphoid approach.MethodsFrom November 2018 to December 2021, 24 patients with anterior mediastinal tumors were treated by thoracoscopic resection through subxiphoid approach in our department. A longitudinal incision about 3 cm in length was made under the xiphoid process as an observation hole, and then two incisions about 1 and 0.5 cm in length were made below the left and right midclavicular rib arch as auxiliary operation holes. The anterior mediastinal tumor resection was completed with an ultrasound scalpel.ResultsAll the 24 patients underwent thoracoscopic thymectomy through a subxiphoid approach. One patient underwent surgery through a small “J” incision in the upper sternum due to the tumor’s large size and involvement of the left cephalic vein and pericardium. The average intraoperative operating time was 65 min (range, 45-150 min), the average intraoperative bleeding was 50 ml (range, 20-100 ml), the average postoperative thoracic tube indwelling time was 2 d (range, 2-4 d), and the average hospital stay was 5 d (range, 3-7 d). One case developed left diaphragmatic paralysis, and no other complications occurred. The 24 cases were followed up for 1-36 months, with a median of 17 months, and no recurrence or metastasis was found.ConclusionThoracoscopic surgery via subxiphoid approach for anterior mediastinal tumors is safe, effective and feasible.

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备注/Memo

备注/Memo:
*通讯作者，Email：chenshixiong2000@163.com
更新日期/Last Update: 2023-08-10